Endoscopic implantation of polymethylmethacrylate augments the gastroesophageal antireflux barrier: a short-term study in a porcine model

Abstract

Endoscopic implantation of PMMA in the distal esophagus augments the antireflux barrier 28 days after the procedure. However, esophageal perforation points to the need for technical refinements to make the procedure safer.

Endoscopic augmentation of the esophagogastric junction with polymethylmethacrylate: durability, safety, and efficacy after 6 months in mini-pigs

“…Eight animals were considered an adequate sample size to detect an increase in GYV of 500 ± 274 ml and an increase in GYP of 2.5 ± 2.0 mmHg, with a = 0.05 and power of 80%, according to data from our previous study [20]. Data are presented as mean ± standard error of the mean (SEM), unless otherwise stated.…”

“…We recently published an experimental study showing that endoscopic implantation of PMMA augments the gastroesophageal antireflux barrier 28 days after the procedure [20]. However, esophageal perforation and animal death pointed to the need for technical refinements.…”

“…The solution is characterized by a white color and high viscosity, determined by a resorbable hydrogel. PMMA was provided in 3-ml syringes, allowing easy adaptation to an ''implant gun'' as described elsewhere [20].…”

“…Six months later, LES manometry and gastric yield measurements were repeated and animals sacrificed as described elsewhere [20].…”

“…Additionally, a significant augmentation of the antireflux barrier after implantation of PMMA has been reported by us in an experimental short-term study. However, esophageal perforation followed by death raised concern about procedure safety [20].…”